“Back to Normal,” by Enrico Gnaulati

This thoughtful piece in the New Yorker On-line has gotten some attention in recent weeks. It discusses this recent book by Enrico Gnaulati and its take on the difficulties of diagnosis, focusing particularly on what to do when fairly normal behavior becomes “pathologized” in the popular imagination.

The question of overdiagnosis is an ongoing conversation within New York psychology and psychoanalysis circles. Although many people fall into one camp or another – either believing wholeheartedly in the gospel of the DSM, or rejecting any checklist-like approach altogether – the truth is often far more nuanced.

There is no question that some disorders of the mind are likewise disorders of the brain – witness the chemical storms of schizophrenia and psychosis. Other symptoms may be more hybrid in nature – for example, Depression or Obsessive Compulsive Disorder, both of which can exist either as wholly chemical, or as wholly psychological maladies. And then there are those issues which are clearly emotional in origin – such as loneliness and relationship difficulties. At least for this last category, some labels do little to illuminate or alleviate the problems.

As the author notes, the principal limitation with the book is that it paints Attention Deficit and Hyperactivity (ADHD) and Autism Spectrum Disorders with the same reductive brush:

Psychiatric labels in kids have large consequences, and overdiagnosis carries risks: unnecessary pharmaceutical treatment, self-image questions, and the potential for long-term stigma. Yet underdiagnosis does, too, because early intervention can greatly improve outcomes for children, especially those with Autism Spectrum Disorder.

The surest way to discover what is causing your emotional symptoms and distress is to talk about with an expert in analytic therapy. PPSC is comprised of several psychotherapists who specialize in particular subspecialties of talk therapy such as LGBT therapy or depression therapy. You can begin your search here today.